Exploratory Laparotomy

Intestinal ischemia following aortic reconstruction is a severe complication with 1% mortality. Although the manifestations of colon ischemia become obvious in the early postoperative course. In the case presented here, sigmoid rupture and small and large intestine communication was revealed three months following repair of the abdominal aorta. A 71-year old man, following open repair of an abdominal aortic aneurysm went home on the 5th postoperative day. Three months later was admitted to the emergency department of our hospital, because of fever, diarrhea and abdominal pain for four days. After conservative treatment and improvement of symptoms, the patient was released only to return to hospital with the same symptoms after a month. On this second admission the symptoms were initially mild and the patient seemed to improve, but suddenly the clinical situation was deteriorated and an exploratory laparotomy was conducted, which revealed a communication between the sigmoid and the small intestine. A left hemicolectomy was
It requires colon segment resection and stoma formation, increasing the length of hospitalization and medical care of the patient. The factors associated with the development of ischemic colitis are mainly emergencies, that require open repair of abdominal aortic aneurysm, with hypotensive episodes and massive transfusions. The risk is greater in women, diabetes and patients with preoperative renal and respiratory failure. The incidence of ischemic colitis is three times greater in the open repair of abdominal aortic aneurysm in relation to the endovascular repair. However, multivariate analyzes showed no statistically significant correlation between the two techniques and the majority of the literature showed limited results for small